<?php include "header.php"?>
<?php include "ButtonPanel.php"?>
  
<div id = "Registration form">
<form action="rp.php" method = "post">
  <p id = "Birthday">Date of Birth:
<select name="dobm" class = "dob">          
<option value="0" selected="selected">-Month-    </option>
<option value="1">Jan    </option>
<option value="2">Feb    </option>
<option value="3">Mar    </option>
<option value="4">Apr    </option>
<option value="5">May    </option>
<option value="6">Jun    </option>
<option value="7">Jul    </option>
<option value="8">Aug    </option>
<option value="9">Sep    </option>
<option value="10">Oct    </option>
<option value="11">Nov    </option>
<option value="12">Dec      </option></select>
<select name="dobd" class = "dob">          
<option value="-Day-">-Day-    </option>
<option value="1">1    </option>
<option value="2">2    </option>
<option value="3">3    </option>
<option value="4">4    </option>
<option value="5">5    </option>
<option value="6">6    </option>
<option value="7">7    </option>
<option value="8">8    </option>
<option value="9">9    </option>
<option value="10">10    </option>
<option value="11">11    </option>
<option value="12">12    </option>
<option value="13">13    </option>
<option value="14">14    </option>
<option value="15">15    </option>
<option value="16">16    </option>
<option value="17">17    </option>
<option value="18">18    </option>
<option value="19">19    </option>
<option value="20">20    </option>
<option value="21">21    </option>
<option value="22">22    </option>
<option value="23">23    </option>
<option value="24">24    </option>
<option value="25">25    </option>
<option value="26">26    </option>
<option value="27">27    </option>
<option value="28">28    </option>
<option value="29">29    </option>
<option value="30">30    </option>
<option value="31">31       </option>
</select>        
<select name="doby" class = "dob">           <option value="-Year-">-Year-    </option><option value="2000">2000    </option><option value="1999">1999    </option><option value="1998">1998    </option><option value="1997">1997    </option><option value="1996">1996    </option><option value="1995">1995    </option><option value="1994">1994    </option><option value="1993">1993    </option><option value="1992">1992    </option><option value="1991">1991    </option><option value="1990">1990    </option><option value="1989">1989    </option><option value="1988">1988    </option><option value="1987">1987    </option><option value="1986">1986    </option><option value="1985">1985    </option><option value="1984">1984    </option><option value="1983">1983    </option><option value="1982">1982    </option><option value="1981">1981    </option><option value="1980">1980    </option><option value="1979">1979    </option><option value="1978">1978    </option><option value="1977">1977    </option><option value="1976">1976    </option><option value="1975">1975    </option><option value="1974">1974    </option><option value="1973">1973    </option><option value="1972">1972    </option><option value="1971">1971    </option><option value="1970">1970    </option><option value="1969">1969    </option><option value="1968">1968    </option><option value="1967">1967    </option><option value="1966">1966    </option><option value="1965">1965    </option><option value="1964">1964    </option><option value="1963">1963    </option><option value="1962">1962    </option><option value="1961">1961    </option><option value="1960">1960    </option><option value="1959">1959    </option><option value="1958">1958    </option><option value="1957">1957    </option><option value="1956">1956    </option><option value="1955">1955    </option><option value="1954">1954    </option><option value="1953">1953    </option><option value="1952">1952    </option><option value="1951">1951    </option><option value="1950">1950    </option><option value="1949">1949    </option><option value="1948">1948    </option><option value="1947">1947    </option><option value="1946">1946    </option><option value="1945">1945    </option><option value="1944">1944    </option><option value="1943">1943    </option><option value="1942">1942    </option><option value="1941">1941    </option><option value="1940">1940    </option><option value="1939">1939    </option><option value="1938">1938    </option><option value="1937">1937    </option><option value="1936">1936    </option><option value="1935">1935    </option><option value="1934">1934    </option><option value="1933">1933    </option><option value="1932">1932    </option><option value="1931">1931    </option><option value="1930">1930    </option><option value="1929">1929    </option><option value="1928">1928    </option><option value="1927">1927    </option><option value="1926">1926    </option><option value="1925">1925    </option><option value="1924">1924    </option><option value="1923">1923    </option><option value="1922">1922    </option><option value="1921">1921    </option><option value="1920">1920    </option><option value="1919">1919    </option><option value="1918">1918    </option><option value="1917">1917    </option><option value="1916">1916    </option><option value="1915">1915    </option><option value="1914">1914    </option><option value="1913">1913       </option></select>
</p>



 <p id = "Email"> Enter your E-mail: <input type="email" name="usrEmail"></p>
<p id = "Uname">Enter Your Username: <input type="text" name="name"></p>

<p id = "Passkey">Enter Your Password: <input type="password" name = "Pw"></p>

<p>Please prove you are a human by solving this simple math problem(Captcha powered by Securimage): </p>
<p><img id="captcha" src="securimage/securimage_show.php" alt="CAPTCHA Image" /></p>
<p><input type="text" name="captcha_code" size="10" maxlength="6" /></p>

<p><a href="#" onclick="document.getElementById('captcha').src = 'securimage/securimage_show.php?' + Math.random(); return false">[ Different Image ]</a></p>

<p>Do you agree to abide by the rules of this forum?</p>
<p><a href = "ForumRules.php">Forum Rules</a></p>
<p> I Agree:<input type="checkbox" name="rules" value="yes"></p>
<p><input type = "submit" value = "Register"></p>
</form>
</div>


<?php include "footer.php"?>

